eprosartan and Chronic-Disease

The efficacy of ACE-inhibitors and beta blockers is well documented in the therapy of heart failure. As pharmacological mechanisms of ATI-receptor-antagonists differ, an additional positive effect can be expected when combining these drugs.. Eighty patients (67.9 +/- 9.9 years) with severe chronic heart failure receiving long-term medication with diuretics, ACE-inhibitors and partially beta blockers (72.5%), were randomized after clinical recompensation to eprosartan (477.5 +/- 143.7 mg/d), telmisartan (65.9 +/- 17.7 mg), candesartan (11.9 +/- 4.0 mg) or no sartan, according to a prospective study. Haemodynamic measurements by impedance cardiography were performed (mean observation time 15.8 days).. Additional sartan treatment resulted in an improvement of cardiac output from 2.32 +/- 0.69 to 3.12 +/- 1.24 l/min (P = 0.003) in the eprosartan group, from 2.24 +/- 0.59 to 2.76 +/- 0.91 l/min (P = 0.001) in the telmisartan group and from 2.76 +/- 0.84 to 3.11 +/- 0.94 l/min (P = 0.02) in the candesartan group. Furthermore, a significant decrease of the total peripheral resistance was measured under eprosartan (23%; P = 0.002), telmisartan (18%; P = 0.002) and candesartan treatment (11.5%; P = 0.049); in the subgroup of combined therapy with beta blockers, ACE-inhibitors and ATI-antagonists a significant increase in cardiac output was also observed. No change was observed in the control group without additional sartan treatment concerning cardiac output and resistance reduction.. The additional treatment with different ATI-receptor-antagonists resulted in an increase of the cardiac output and a decrease of the peripheral resistance. This beneficial effect may be due to the additional property of sartans to block the interaction of locally and not-ACE-generated angiotensin II with their vascular and myocardial ATI-receptors.

Topics: Acrylates; Adrenergic beta-Antagonists; Aged; Angiotensin II Type 1 Receptor Blockers; Angiotensin-Converting Enzyme Inhibitors; Benzimidazoles; Benzoates; Biomarkers; Biphenyl Compounds; Blood Pressure; Cardiac Output; Chronic Disease; Drug Therapy, Combination; Female; Heart Failure; Heart Rate; Humans; Imidazoles; Male; Middle Aged; Prospective Studies; Severity of Illness Index; Telmisartan; Tetrazoles; Thiophenes; Treatment Outcome; Vascular Resistance

The safety and efficiency of the therapy with the angiotenzin-II receptor blocker--teveten were compared with the ACE inhibitor prestarium and their combination in patients with NYHA functional classes II-III of the chronic heart failure (CHF), who were on conventional therapy with diuretics and cardiac glycosides. The special attention was given to the influence of a combination of teveten and prestarium on morphofunctional performance of the myocardium and vessels, the neurohumoral status, quality of life and survival in patients with left ventricular dysfunction. Our study confirmed that Prestarium or Teveten monotheraphy gives approximately identical result, while their combination have better influence on the quality of life and hemodynamic parameters. The combined use of teveten and the ACE inhibitor prestarium is the most optimal treatment regimen in patients with moderate and severe CHF.

Topics: Acrylates; Antihypertensive Agents; Chronic Disease; Drug Therapy, Combination; Female; Heart Failure; Humans; Imidazoles; Male; Perindopril; Thiophenes